CMS Formulary

Displaying 77781-77790 of 1611142 results.
ID: 77781
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77782
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77783
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77784
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77785
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77786
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77787
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77788
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77789
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 77790
Formulary ID: 00021028
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0